What exactly is ADHD?
Written by: Vanessa Buonopane, Psy.D.
Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that is most often diagnosed in childhood (symptoms must be present prior to age twelve) and can persist into adulthood. While many individuals struggle with attention and focus at times, individuals with ADHD can experience severe symptoms that impact them academically, socially, and in a variety of other settings. Some of the most common symptoms that individuals with ADHD exhibit are:
- Difficulty focusing and paying attention
- Squirming and fidgeting
- Making careless mistakes or not paying attention to details
- Daydreaming often
- Forgetfulness or losing necessary items (e.g., schoolwork, pencils, books, clothing)
- Difficulty taking turns or interrupting others
Many people are unfamiliar with the changes that this diagnosis has been through in the last thirty years, often using ADHD and Attention-Deficit Disorder (ADD) interchangeably. While they are essentially the same condition, our understanding of the diagnosis has grown and the name has been changed to reflect that knowledge. You can still use either acronym, as your doctors and other people will almost certainly understand you; however, ADHD is the most accurate and up-to-date term.
There are three ways that ADHD manifests itself, depending on the predominant symptoms that the individual displays.
- Predominantly Inattentive Presentation: The individual may have difficulty paying attention to details, becomes easily distracted, forgets details of daily routines or previously learned information, struggles to organize and finish tasks, and difficulty following along and keeping up with conversations.
- Predominantly Hyperactive/Impulsive Presentation: The individual may fidget or become restless; have difficulty sitting for long periods; run, jump, or climb constantly; interrupt others during conversations; have difficulty waiting their turn; and may struggle with impulsivity.
- Combined Presentation: The individual struggles with symptoms from both the inattentive presentation and the hyperactive/impulsive presentation. The individual must exhibit six symptoms from each presentation for a total of twelve symptoms to be diagnosed with the combined presentation.
Graphic credit: @ADHD_Alien (Twitter and Instagram)
As children grow up, they may receive intervention or learn strategies to manage their symptoms, ultimately compensating for their difficulties. Because the symptoms of ADHD can change over time, the presentation may change over time as well.
Research suggests that there are several possible causes and risk factors for developing ADHD, including:
- Brain injury
- Exposure to environmental risks (e.g., lead) during pregnancy or at a young age
- Alcohol and tobacco use during pregnancy
- Premature birth
- Low birth weight
There are several other popular views and opinions that are not supported by the research, such as ADHD is caused by eating too much sugar, excessive screen time, parenting styles, and environmental factors (e.g., poverty or family chaos). While these things can certainly exacerbate existing symptoms for individuals with ADHD, the evidence is simply not strong enough to conclude that they are the main cause of ADHD.
Given the significant research done over the years, we now know that many adults have never been diagnosed with ADHD in childhood and continue to experience symptoms in adulthood. While it is possible to diagnose ADHD in adulthood, it is important that the clinician consider when the symptoms began, as they must have been present before age twelve. Symptoms also need to be present in at least two settings (e.g., home, school, work, socially, etc.) and there must be clear evidence that the symptoms interfere with or reduce the quality of the individual’s functioning. A diagnostic intake and psychological evaluation is usually one of the best (and most objective) ways to diagnose ADHD.
In terms of treatment, many individuals find success with a combination of behavioral therapy and medication. Behavioral interventions are typically encouraged prior to medication, which usually includes strategies for parents, especially for young children. Taking care of your physical health is also important and individuals with ADHD are encouraged to develop or maintain healthy eating habits, exercise regularly, limit screen time, and receive adequate sleep each night.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). http://doi.org/10.1176/appi.books.9780890425596
Centers for Disease Control and Prevention (n.d.). What is ADHD? https://www.cdc.gov/ncbddd/adhd/facts.html
(2023, May 23). Are ADD and ADHD the Same Condition? Very Well Mind. https://www.verywellmind.com/is-add-the-same-thing-as-adhd-20467#:~:text=1%EF%BB%BF%20This%20is%20because,name%20from%201980%20to%201987